Neurodevelopmental-Disorders.pptx,docsss

For study purposes

1. NEURODEVELOPMENTAL DISORDERS

2. INTRODUCTION Neurodevelopmental disorders, usually diagnosed in infancy or childhood and sometimes adolescence; many of these disorders persist into adulthood. 20XX Presentation title 2

3. Intellectual Developmental Disorder Is the correct diagnostic term for what was once called mental retardation or intellectual disability, terms often called used in a disparaging manner to bully or ridicule individuals with impaired cognitive abilities. 20XX Presentation title 3

4. CAUSES OF INTELLECTUAL DEVELOPMENTAL DISORDER INCLUDE: Tay-Sachs disease or fragile X chromosome syndrome Early alterations in embryonic development Trisomy 21 or maternal alcohol intake Pregnancy or perinatal problems Medical conditions of infancy Environmental influences

5. AUTISM SPECTRUM DISORDER 20XX Presentation title 5 Is the DSM-5 diagnosis that includes disorders previously categorized as different types of a pervasive developmental disorder (PDD), characterized by pervasive and usually severe impairment of reciprocal social interaction skills, communication deviance, and restricted stereotypical behavioral patterns. Previous PDDs, such as Rett’s disorder, childhood disintegrative disorder, and Asperger’s disorder, are now viewed on a continuum called the autism spectrum. This change helps to eliminate problems that existed when attempting to distinguish among these sometimes similar disorders.

6. 20XX Presentation title 6 ASD, formerly called autistic disorder , or just autism, is almost five times more prevalent in boys than in girls, and it is identified usually by 18 months and no later than 3 years of age. the behaviors and difficulties experienced vary along the continuum from mild to severe. ASD have persistent deficits in communication and social interaction, accompanied by restricted, stereotyped patterns of behavior and interests/activities, display little eye contact with and make few facial expressions toward others; they use limited gestures to communicate; e limited capacity to relate to peers or parents; lack spontaneous enjoyment, express no moods or emotional affect, and may not engage in play or make-believe with toys; and little intelligible speech.

7. Stereotyped motor behaviors such as hand flapping, body twisting, or head banging BOX 22.1 Behaviors Common With ASD 20XX Presentation title 7

8. Eighty percent of cases of autism are early onset, with developmental delays starting in infancy. The other 20% of children with autism have seemingly normal growth and development until 2 or 3 years of age, when developmental regression or loss of abilities begins. Autism does have a genetic link; many children with autism have a relative with autism or autistic traits. Controversy continues about whether measles, mumps, and rubella (MMR) vaccinations contribute to the development of late-onset autism. Autism tends to improve, in some cases substantially, as children start to acquire and use language to communicate with others. If behavior deteriorates in adolescence, it may reflect the effects of hormonal changes or the difficulty meeting increasingly complex social demand. 20XX Presentation title 8

9. RELATED DISORDERS Tic Disorders - A tic is a sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization. Tics can be suppressed but not indefinitely. Common simple motor tics include: blinking, jerking the neck, shrugging the shoulders, grimacing, and coughing. Common simple vocal tics include: clearing the throat, grunting, sniffing, snorting, and barking. Complex vocal tics include: repeating words or phrases out of context, coprolalia (use of socially unacceptable words, frequently obscene), palilalia (repeating one’s own sounds or words), and echolalia (repeating the last-heard sound, word, or phrase). Complex motor tics include: facial gestures, jumping, or touching or smelling an object. 20XX Presentation title 9

10. Tourette’s disorder involves multiple motor tics and one or more vocal tics, which occur many times a day for more than 1 year. The complexity and severity of the tics change over time, and the person experiences almost all the possible tics described previously during his or her lifetime. Chronic Motor or Tic Disorder - Chronic motor or vocal tic differs from Tourette’s disorder in that either the motor or the vocal tic is seen, but not both. Transient tic disorder may involve single or multiple vocal or motor tics, but the occurrences last no longer than 12 months. 20XX Presentation title 10

11. Learning Disorders - A specific learning disorder is diagnosed when a child’s achievement in reading, mathematics, or written expression is below that expected for age, formal education, and intelligence. Low self-esteem and poor social skills are common in children with learning disorders. As adults, some have problems with employment or social adjustment; others have minimal difficulties. Motor Skills Disorder - The essential feature of developmental coordination disorder is impaired coordination severe enough to interfere with academic achievement or activities of daily living. This diagnosis is not made if the problem with motor coordination is part of a general medical condition such as cerebral palsy or muscular dystrophy. Its course is variable; sometimes lack of coordination persists into adulthood. 20XX Presentation title 11

12. Stereotypic movement disorder is characterized by rhythmic, repetitive behaviors, such as hand waving, rocking, head banging, biting, that appears to have no purpose. Onset is prior to age 3 years, and usually persists into adolescence. It is more common in persons with intellectual disability. Communication Disorders - is diagnosed when a communication deficit is severe enough to hinder development, academic achievement, or activities of daily living, including socialization. Expressive language disorder involves an impaired ability to communicate through verbal and sign languages. Mixed receptive–expressive language disorder includes the problems of expressive language disorder along with difficulty understanding (receiving) and determining the meaning of words and sentences. 20XX Presentation title 12

13. Phonologic disorder involves problems with articulation (forming sounds that are part of speech). Stuttering is a disturbance of the normal fluency and time patterning of speech. Communication disorders may be mild to severe. Difficulties that persist into adulthood are related most closely to the severity of the disorder. Elimination Disorders - Encopresis is the repeated passage of feces into inappropriate places such as clothing or the floor by a child who is at least 4 years of age either chronologically or developmentally. It is often involuntary, but it can be intentional. Enuresis is the repeated voiding of urine during the day or at night into clothing or bed by a child at least 5 years of age either chronologically or developmentally. Most often enuresis is involuntary; when intentional, it is associated with a disruptive behavior disorder. 20XX Presentation title 13

14. Sluggish cognitive tempo (SCT) – is a syndrome that is not a DSM-5-TR diagnosis. It includes day dreaming, trouble focusing and paying attention, mental fogginess, staring, sleepiness, little interest in physical activity, and slowness in finishing tasks. 20XX Presentation title 14

15. ATTENTION-DEFICIT / HYPERACTIVITY DISORDER Is characterized by inattentiveness, overactivity, and impulsiveness. A common disorder, especially in boys, and probably accounts for more child mental health referrals than any other single disorder. The essential feature of ADHD is a persistent pattern of inattention and/or hyperactivity and impulsivity more common than generally observed in children of the same age. 20XX Presentation title 15

16. Onset and Clinical Course Attention deficit hyperactivity disorder usually is identified and diagnosed when the child begins preschool or school, although many parents report problems from a much younger age. Toddlers may be described as “always on the go” and “into everything,” at times dismantling toys and cribs. They dart back and forth, jump and climb on furniture, run through the house, and cannot tolerate sedentary activities such as listening to stories. Symptoms of ADHD begin to interfere significantly with behavior and performance. Normal environmental noises, such as someone coughing, distract the child. He or she cannot listen to directions or complete tasks. 20XX Presentation title 16

17. This perception results from the child’s impulsivity, inability to share or take turns, tendency to interrupt, and failure to listen to and follow directions. Thus, peers and teachers may exclude the child from activities and play, may refuse to socialize with the child, or may respond to the child in a harsh, punitive, or rejecting manner. Children diagnosed with ADHD continue to have problems in adolescence. Typical impulsive behaviors include cutting class, getting speeding tickets, failing to maintain interpersonal relationships, and adopting risk-taking behaviors, such as using drugs or alcohol, engaging in sexual promiscuity, fighting, and violating curfew. 20XX Presentation title 17

18. Previously, it was believed that children outgrew ADHD, but it is now known that ADHD can persist into adulthood. Estimates are that 60% of children with ADHD have symptoms that continue into adulthood. 20XX Presentation title 18

19. Etiology Although much research has taken place, the definitive causes of ADHD remain unknown. There may be cortical-arousal, information-processing, or maturational abnormalities in the brain. Combined factors, such as environmental toxins, prenatal influences, heredity, and damage to brain structure and functions, are likely responsible. Prenatal exposure to alcohol, tobacco, and lead and severe malnutrition in early childhood increase the likelihood of ADHD 20XX Presentation title 19

20. Brain images of people with ADHD suggest decreased metabolism in the frontal lobes, which are essential for attention, impulse control, organization, and sustained goal-directed activity. Risk factors for ADHD include family history of ADHD; male relatives with antisocial personality disorder or alcoholism; female relatives with somatization disorder; lower socioeconomic status; male gender; marital or family discord, including divorce, neglect, abuse, or parental deprivation; low birth weight; and various kinds of brain insult. 20XX Presentation title 20

21. CULTURAL CONDITIONS The Child Behavior Checklist, Teacher report Form, and Youth Self Report (for ages 11-18 years) are rating scales frequently used to determine problem areas and competencies. These scales are often part of a comprehensive assessment of ADHD in children. The ADHD-FX has also proved to be valid, reliable, and culturally appropriate measure of functional impairment of at risk students. 20XX Presentation title 21

22. TREATMENT None has been found to be effective for ADHD, this gives rise to many different approaches such as sugar-controlled diets and megavitamin therapy. ADHD is chronic; goals of treatment involve managing symptoms, reducing hyperactivity and impulsivity, and increasing the child's attention so that he or she can grow and develop normally. 20XX Presentation title 22

23. PSYCHOPHARMACOLOGY The most common medical are methylphenidate (Ritalin) and amphetamine compound (Adderall) . Methylphenidate is 70% to 80%of children with ADHD; it reduces hyperactivity, impulsivity and mood liability and helps the child pay attention more appropriately. Dextroamphetamine (Dexedrine) and pemoline ( Cyclert ) are other stimulant used to treat ADHD. The most common side effects of these drugs are insomnia, loss appetite, and loss weight or failure to gain weight. 20XX Presentation title 23

24. 20XX Presentation title 24 Drug Used to Treat ADHD

25. STRATEGIES FOR HOME AND SCHOOL Environmental strategies at school and home can help the child succeed in those settings. Educating parents and helping them with parenting strategies are crucial components of effective treatment of ADHD. Effective approaches include providing consistent rewards and consequences for behavior, offering consistent praise, using time-out, and giving verbal reprimands. 20XX Presentation title 25

26. CARE OF CLIENTS WITH ATTENTION-DEFICIT / HYPERACTIVITY DISORDER ASSESSMENT DATA HISTORY - The child probably has difficulties in all major life areas such such as school or play, and he or she likely displays overactive or even dangerous behavior at home. GENERAL APPEARANCE AND MOTOR BEHAVIOR- The child sit still in a chair and and squirms ang wigles while to do so. MOOD AND AFFECT- Mood may be liable, even to the point of verbal out bursts or temper tantrums. Agitation, frustration, and agitation are common. THOUGHT PROCESS AND CONSENT- There are generally no impairments in this area, though assessment can be difficult depending on the child's activity level and age or developmental stage. 20XX Presentation title 26

27. SENSORIUM AND INTELLECTUAL PROCESS ES- The child is alert and oriented with no sensory or perceptual alterations such as hallucinations. JUDGEMENT AND INSIGHT- Children with ADHD usually exhibit poor judgment and often do not think before acting. Children with ADHD display more lack of judgement compared with others of the same age SELF-CONSEPT - May be difficult to assess in very young child, but generally, the self-esteem of children with ADHD is low. ROLES AND RELATIONSHIPS- The child usually unsuccessful academically and socially at school. PSYSIOLOGICAL AND SELF-CARE CONSIDERATIONS- Children with ADHD may be thin if they do not take time to eat properly or cannot sit through meals. 20XX Presentation title 27

28. DATA ANALYSIS AND PRIORITIES Nursing diagnosis used when working with children with ADHD include: Risk for injury Ineffective role performance Impaired social interaction Compromised family coping 20XX Presentation title 28

29. OUTCOME IDENTIFICATION Treatment outcomes for clients with ADHD may include: The client will be free of injury The client will not violate the boundaries of others. The client will demonstrate age-appropriate social skills The clients will complete tasks The client will follow directions 20XX Presentation title 29

30. NURSING INTERVENTIONS For ADHD Ensuring the child’s safety and that of others Stop unsafe behavior Provide close supervision Give clear direction about acceptable and unacceptable behavior. Improved role performance Give positive feedback for meeting expectations. Manage the environment (e.g., provide a quiet place free of distraction for task completion). 20XX Presentation title 30

31. Simplifying instructive/directions Get child's full attention. Break complex tasks into small steps. Allow breaks Structured daily routine Establish a daily schedule Minimize changes Client/Family education and support: listen to parents feelings and frustrations. 20XX Presentation title 31

32. CLIENTS AND FAMILY EDUCATION AND SUPPORT listen to parents feelings and frustrations. For ADHD include parents in planning and providing care refers parents to support focus on child's strengths as well as problems teach accurate administration of medication and possible side effects. inform parents that child is eligible for special school services assist parents in identifying behavioral approaches to be used at home help parents achieve balance of praising Emphasize the need for structure and consistency in child's routine and behavioral expectations. 20XX Presentation title 32

33. EVALUATION Parents and teachers are likely to notice positive out-comes of treatment before the child does . Medications are often effective in decreasing hyperactivity and impulsivity and improving attention relately quickly if the childs responds to them. Improved sociability, peer relationships, and academic achievements happen more slowly and academic achievements Happen more slowly and gradually but are possible with effective treatment. 20XX Presentation title 33

34. THANK YOU 20XX Presentation title 34